局麻无管化经皮肾镜取石术78例报告  

Tubeless Percutaneous Nephrolithotomy Under Local Anesthesia(Report of 78 Cases)

作　　者：龙大治 彭雪薇 熊思清[1] 傅恩君[1] 黄冬莲[1] LONG Dazhi;PENG Xuewei;XIONG Siqing;FU Enjun;HUANG Donglian(Department of Urology,Ji'an Central People's Hospital,Ji’an Jiangxi 343000,China)

机构地区：[1]吉安市中心人民医院泌尿外科

出　　处：《中国继续医学教育》2019年第34期114-117,共4页China Continuing Medical Education

摘　　要：目的探讨局麻无管化经皮肾镜取石术的可行性与安全性。方法回顾性分析78例在局麻下实施无管化经皮肾镜取石术患者临床资料。其中肾结石52例,输尿管上段结石17例,输尿管上段结石合并肾结石9例。结石大小(2.3±1.1)cm。通过视觉模拟疼痛评分及镇痛药的需求评估疼痛程度。结果 78例手术均顺利完成,其中18例双J管亦未留置(完全无管化)。总结石清除率98.5%。术中平均视觉模拟疼痛评分(4.1±2.8)分。按照Clavien-Dindo分级系统,本组Ⅰ级并发症19例(24.35%),无Ⅱ级以上并发症发生。结论严格选择病例在局麻下实施无管化经皮肾镜取石术简单安全有效,术后疼痛轻、恢复快,值得临床推广应用。Objective To discuss the feasibility and safety of tubeless percutaneous nephrolithotomy(PCNL) under local anesthesia. Methods The data of 78 cases receiving tubeless PCNL under local anesthesia were summarized retrospectively. Including 52 patients had renal calculi, 17 patients had upper ureteral calculi and 9 patients had upper ureteral calculi complicated with renal calculi. Mean stone size was(2.3±1.1) cm in diameter. The pain degree was evaluated by visual analog scale(VAS) and the demand for analgesics. Results All of the patients successfully received tubeless PCNL under the local anesthesia. Of the 78 patients, 18 patients had total tubeless PCNL. The overall stone-free rate was 98.5%. The mean VAS in operation was(4.1±2.8) score. The complications in PCNL were evaluated by the Clavien-Dindo grading system, grades Ⅰ was 19 cases(24.35%), no complications above grade Ⅱ occurred. Conclusions Tubeless PCNL handled under local anesthesia was simple safe and effective for the indication patients, it showed less pain, shorter hospital stay, deserved clinical popularizing use.

关 键 词：局麻 无管化 上尿路结石 经皮肾镜取石术 造瘘管 并发症 

分 类 号：R692.4[医药卫生—泌尿科学]